Smith Michael P, Olatunde Olugbenga, White Chris
Office for National Statistics.
Health Stat Q. 2010 Summer(46):51-68. doi: 10.1057/hsq.2010.11.
BACKGROUND: Deprivation and ill health are intimately linked. Monitoring this relationship in detail and with sufficient frequency is key in attempts to reduce health inequalities through more efficient targeting of healthcare resources. This study explores the potential of the General Household Survey (GHS) to provide an inter-censal measure of health expectancies in small areas experiencing differing degrees of deprivation. METHODS: The prevalence of health status and the health expectancy of males and females at birth and at age 65 by quintiles of small area deprivation are estimated. Comparisons are made between census 2001 and GHS 2001-05 to inform the suitability of the latter as an inter-censal measure of health expectancy across small areas. Comparisons are also made between the health expectancies of people living in more and less deprived areas. RESULTS: Reports of 'good' and 'fairly good' health fell and health expectancies declined as deprivation increased. Consistency between census and GHS data indicates that the latter is a suitable source for the inter-censal measurement of health expectancies across quintiles of deprivation. At birth, people living in the least deprived areas can expect more than 12 additional years of life in good or fairly good health than those in the most deprived areas, at age 65 the difference was more than four years. In terms of the proportion of life spent in favourable health states; at birth, those living in the least deprived areas could expect to spend around 91 per cent or more of their lives in good or fairly good health compared to 82 per cent for those in the most deprived areas. At age 65, people in the least deprived areas could expect to spend around 82 per cent of their remaining life in good or fairly good health compared to 69 per cent or less for those in the most deprived areas. CONCLUSIONS: This study represents the first use of the Index of Multiple Deprivation (IMD) 2004 in the measurement of health expectancy across small areas. Both the census and GHS highlighted substantial differences in the health status and health expectancies of people experiencing differing degrees of ecological deprivation. These findings serve as a useful measure and benchmark in the targeting and assessment of interventions designed to ameliorate health inequalities.
背景：贫困与健康状况不佳密切相关。详细且高频地监测这种关系是通过更有效地分配医疗资源来减少健康不平等现象的关键。本研究探讨了综合住户调查（GHS）在为经历不同程度贫困的小区域提供两次人口普查期间健康期望寿命衡量指标方面的潜力。 方法：按小区域贫困程度五分位数估计出生时及65岁时男性和女性的健康状况患病率及健康期望寿命。对2001年人口普查数据和2001 - 2005年综合住户调查数据进行比较，以了解后者作为小区域间健康期望寿命普查期间衡量指标的适用性。还对生活在贫困程度较高和较低地区的人群的健康期望寿命进行了比较。 结果：随着贫困程度加剧，“良好”和“尚可”健康状况的报告减少，健康期望寿命下降。人口普查数据与综合住户调查数据之间的一致性表明，后者是跨贫困程度五分位数进行普查期间健康期望寿命衡量的合适数据来源。出生时，生活在贫困程度最低地区的人比最贫困地区的人预期在良好或尚可健康状态下多活12年以上；在65岁时，这一差异超过四年。就处于良好健康状态的生命比例而言，出生时，生活在贫困程度最低地区的人预期其生命中约91%或更多时间处于良好或尚可健康状态，而最贫困地区的人这一比例为82%。在65岁时，贫困程度最低地区的人预期其剩余生命中约82%的时间处于良好或尚可健康状态，而最贫困地区的人这一比例为69%或更低。 结论：本研究首次使用2004年多重贫困指数（IMD）来衡量小区域的健康期望寿命。人口普查和综合住户调查均突显了经历不同程度生态贫困的人群在健康状况和健康期望寿命方面的显著差异。这些发现为旨在改善健康不平等现象的干预措施的定位和评估提供了有用的衡量标准和基准。
Soc Sci Med. 2005-6
Int J Equity Health. 2014-9-20
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